Wiki Apligraf

[efuhrmann]

Iam coding this as 15340-KX and Q4101-KX with diag code 707.12 to Trailblazer's. Denied for med necessity. Can someone shed some light on this scenario?

 

[efuhrmann]

Once again, is anyone using this skin substitute?

 

[mhanson1]

Have you checked your LCD for Application of Bioengineered Skin Substitutes? I am not familiar with Trailblazer, as Iowa is under WPS (Wisconsin Physician Services). Our LCD policy shows that WPS will only cover this service for neuropathic diabetic foot ulcers. We need to code the ulcer primary, and the appropriate diabetic code second.

Hope that helps.

Michelle Hanson, CPC